Sunday, August 3, 2014

a little more clinical detail

Someone asked for an example of how I might be more active with a less regressed patient.

I wrote this out a little while ago and shared it on Michael Eigen's group.

We are talking about her parents and how her mother is a workaholic and doesn't seem to care that her post-heart-attack father is killing himself by smoking, working too much, and generally not changing his lifestyle.

She's formulating that her mother is is afraid to see it and deal with it. I ask her how it feels to say 'my mom is too weak to deal with it'

she says it, hesitates, and says she's not sure and begins to complain about her physical symptoms of back ache and headache. She talks about it and says that she feels like she is being crushed.

I ask her to picture a scene of someone or thing crushing another person or thing. She pictures a giant foot that comes down on her and crushes her into the ground.

I ask her to describe the foot and she says she hates feet and it's disgusting, ugly, and smelly.

I ask her to turn these into I-statements and she identifies as feeling disgusting and then says that she's recently had acne and has felt fat and that she "hates her body"

I ask her if she would leave her body if she could and what that would look like.

She says that she would leave her body through her mouth and that she'd be up in the sky and in the sunlight feeling the light and feeing good.

I interpret that her soul would be free to be in the light but while still in her body she has to hide in her room in the darkness (she isolates a lot and had mentioned laying in bed in her room with the lights off). 

She goes on to say that her body is sick and stopping her from going forward and from "achieving what she can achieve" (She had previously talked about applying to med school but still hadn't finished the applications) 

I ask her how it feels if she says "I am stopping myself from going forward and I am stopping myself from achieving what I can achieve"

She says it feels true. She says that she hasn't been working hard enough and is not strong enough to do it and she gives up too easily.

I interpret that she won't try to do anything and therefore won't have to be aware that she can't achieve her goals and do things perfectly. (I have seen this patient for close to two years and her perfectionism has been something we've returned to constantly. As the opening content may indicate her phallic nuclear complexes (both active and passive) are gathering more energy as earlier fixations have been dealt with. However, her volar stage fixations are still very strong and when anything goes wrong in her life isolation is still her strongest defense.)   

She responds, "if it's not perfect then it's not worth it"

I ask her the last time she felt like she could have accomplished it. She said a few weeks ago before a big fight with her room-mate (in which he told her she was fat, ugly, would be a nobody, took forever to finish school, and everything he could say to hurt her)

She focuses on the bodily comments he made to her and I again challenge her that she is putting all that's bad about her into her body.

She says that she's "captured in it". Captured sounds significant so I ask her for her association.

She says that she thinks of prisoners captured in war.

I ask what the army does to the captured soldiers and she laughs and says that now she feels captured by me and she knows that I'm going to treat the soldiers like a part of her.

She feels trapped by my questions and I ask her what I want. She says I want her "secrets"
She said she would never tell them to anyone. I ask what I would think about her if she told me

She says I would feel sorry for he, look down on her, or pity her and she'd rather be hated than pitied.

I interpret that I'll look down on her and then crush her because that it what she deserves.

She laughs uncomfortably. silence. She says that she will never tell.

I interpret that she will continue to punish herself for her "secrets" and hide away in her room and blame everything on her body, rather than show me that her soul is disgusting.

She says that she can't tell me (because she's ashamed...)


she still didn't tell me this session. She said that she can only imagine someone evil seeing her and gloating. I asked her why she wouldn't let me care for her and she said that she can't believe that anyone cares. i interpreted that her father is killing himself and she can't care if he doesn't care, but it ended at a stalemate in which she can only expect evil, she identifies with evil and she feels that whatever is good in her is a weakness. 

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